meditsiinilahendused tulevikus madis tiik md. ,phd. 20.02 · •overall health spending accounts...
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Meditsiinilahendused tulevikus
Madis Tiik MD. ,PhD.
20.02.2016
• Tartu University, medical doctor 1996
• Tartu University, family doctor 2000
• Nordic School of Public Health (Sweden) -Diploma in
Public Health 2003
• Estonian Business School 2001-2003 ICT Management
• Tallinn University of Technology, PhD (healthcare
engineering) 2012
• Scripps Translational Science Institute, San Diego,USA
2014-2015 Digital Medicine intern
MINU VIIMASTE AASTATE
TEGEMISED
• Alates 2012 septembrist Soome Innovatsioonifond Sitra vanem konsultant.– Xtee tutvustamine ja idee selle rakendamisest Soomes• 2013 Soome valitsuse IT strateegia üks peamisi eesmärke – xtee
kasutuselevõtt
• 18.12.2015 Soome xtee toodangus
• 2016-2017 avaliku sektori teenused x teele
– Virtuaalkliinik• 2014-2015 Piloot Hämenlinnas
• 2016-2018 laieneb kogu Soomele
– Tervishoiu rahastamise reform 2015-2017
– Terviseandmete operaatorteenus Isaacus 2015-2017
TRENDID
• Terviseteenuste nõudluse kasv
• Virtuaalteenuste kasutamine
suureneb
• Uued nutikad seadmed
• Informatsiooni hulk suureneb
• Rõhuasetus ennetusele
TERVISETEENUSTE TURG
• “DURING THE NEXT 10 YEARS 5 BILLION NEW CLIENTS WILL
ENTER INTO THE HEALTHCARE SERVICES MARKET” - FORBES
• MOBILE TECHNOLOGIES ARE INCREASINGLY ACCESSIBLE AND
CHEAPER
• Overall health spending accounts for approx. 9 % of GDP in OECD countries (e.g. Finland 9,1 & USA 16,9 %)
• Global health spending growth will be 5-6 % / p.a. between 2014-2017
• Healthcare systems are facing challenges • such as
• aging population• chronic diseases• uneven quality• imbalanced access to care etc.
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HEALTHCARE COSTS ARE RISING – COST-EFFECTIVE SOLUTIONS
ARE NEEDED
”Silver
tsunami”
Source: http://www2.deloitte.com/content/dam/Deloitte/dk/Documents/
life-sciences-health-care/Global-health-care-2014.pdf
Brazil205M population
53% Internet penetration
140% mobile penetration
Kenya38,6M population
58% Internet penetration
83% mobile penetration
Malaysia30,9M population
66% Internet penetration
130% mobile penetration
Finland5,5M population
91,5% Internet penetration
Tansania51M population
26% Internet penetration
76% mobile penetration
Estonia1,3M population
84% Internet penetration
Sweden9,8M population
95% Internet penetration
MOBIILTEHNOLOOGIA VÕIMALDAJANA
E-VISIIT
• MD live (US)
• BabylonHealth (UK)
• Meedoc (FIN)
• Netiarst (EST)
• Virtuwell (US)
E-VISIIDI MAJANDUSLIK EFEKTIIVSUS
CASE ’VIRTUWELL’ - 24/7 ONLINE CLINIC THAT
TREATS EVERYDAY MEDICAL CONDITIONS (USA)• staffed by board certified nurse practitioners• a personalized diagnosis, a treatment plan and a prescription if you need it - all
in about 30 minutes and all online• If symptoms or medical history suggest that online care is not appropriate,
patient is redirected to doctor's office, test lab, physical exam etc.
So far Virtuwell has had 100,000 completed visits:
an average savings of $88 per visitone Virtuwell visit can save up to 2,5 hours as indicated by
Virtuwell customers98 % of customers recommend the service
Source: http://www.businesswire.com/news/home/20140617005116/en/virtuwell-surpasses-100000-cases-treated#.U6LBG_mSx1Y
PATSIENTIDE VALMISOLEKS E-TEENUSTEKS
The Accenture online survey of 1,110 U.S. patients (06/2012):• 90 % want to self-manage their healthcare leveraging
technology, such as accessing medical information, refilling prescriptions and booking appointments online
• 90 % prefer web-based access to health information and education to help manage conditions
Similarly, Cisco study (2013) that includes 1,547 responses across ten countries,reveals that 74% of consumers are open to virtual doctor visit
Sources: http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Is-Healthcare-Self-Service-Online-Enough-to-Satisfy-Patients.pdf; http://newsroom.cisco.com/release/1148539/Cisco-Study-Reveals-74-Percent-of-Consumers-Open-to-Virtual-Doctor-Visit
In 2013, Sitra conducted an interview survey that included 1085 Finnish citizens:• 70 % think eHealth services are beneficial for them• 74 % want more eHealth services
More than 2,400 Canadians participated in PwC’s research: “What does the future of health care delivery look like?• 79% of Canadians indicate that they are comfortable with
virtual monitoring for chronic conditions• 54% of Canadians indicate that virtual visits, home
monitoring, and virtual wards are good care delivery options
Source: https://coachorg.com/en/communities/resources/ATA_Fall_Forum_Presentations/ATA_Toronto_Falk_Sept_10_2013_Final.pdf
PATSIENTIDE VALMISOLEKS E-TEENUSTEKS
AGA ARSTID?
80 % of US physicians believe virtual
assistants will drastically change
healthcare by 2018 Nuance Communications survey 02/2013)
80 % of Spanish health professionals would be willing to use telemedicine
if it were available to them (Telefonica 2013)
59 % of Canadian physicians believe
that the use of mHealth tools and
virtual care is inevitable, but adoption
will take time (PwC’s survey 09/2013)
IT GIGANDID ON LIIKUMAS
Sitra • Ville Koiste • 04.09.2014 •
Sources: The Verge
15.10.2013; WSJ
28.5.2014; Forbes
22.8.2014
Virtual clinic• Data integration and mining
• Decision support
Research and reference database• Cohorts
• Biobanks
• Research articles
Electronic health records
Citizen’s interface, e.g. webpage/mobile
application
eService portal & booking tool
(e.g. palveluvaaka.fi)
Virtual health check
Mobile & walk-in service channels, remote
consultations
Pic. sources: Intel Free Press, flickr.com/photos/neven/, Healthspot.com
Personal health records• Health & wellness data
• Genetic data
Health information & personal risk assesment
THE IPHONE AS A ..
• Otoscope (CellScope)• Portable EKG (AliveCor)• Microscope• GLUCOMETER : (IBGStar)• DERMATOSCOPE (Handyscope)• Ultrasound (Mobisante)• BLOOD PRESSURE Monitor (Withings)• SPIROMETER (SpiroSmart App)• Alcohol Breathalyzer (iPega)• Brain SCANNER• Eye Clinic (PEEK VISION)• Ophtalmoscope (Welch Allyn)
eHealth is
transforming
healthcare and
potentially saving lives,
especially in low-
income countries
CLINICLOUD’S SMART STETHOSCOPE AND THERMOMETER LET DOCTORS CHECK YOUR VITALS FROM THE
CLOUD
SCANADU’S NEW PEE STICK PUTS THE MEDICAL LAB ON YOUR
SMARTPHONE
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PROTEUS DIGITAL HEALTH
Sources: ScienceTranslationalMedicine.org 15
April 2015 Vol 7 Issue 283 http://www.stsiweb.org/wp-
content/uploads/2015/04/Sci-Transl-Med-2015-Steinhubl.pdf &
http://ww2.kqed.org/futureofyou/2015/09/02/how-tiny-sensors-are-driving-
innovation-in-medicine/;
Health Care
Environmental &
social factors
Genetics
Behaviour &
lifestyle
TERVIST MÕJUTAVAD FAKTORID
McGinnis, et al., Health Affairs; 21(2), 2002
ELUSTIILIGA VÕIMALIK VÄLTIDA
Cardiovascular disease: 73-
83% (Nurses Health Study, NEJM 2000;343:16-22, NEJM 2001;345:790-97)
Diabetes type II: 58-91% (Tuomilehto, 2001
NEJM 344(18): 1343-50 Nurses Health Study, NEJM 2000;343:16-22, NEJM 2001;345:790-97)
Cancer: 60-69% (De Lorgeril, Arch Int Med 1998;158:1181-87
HALE Project. Knoops JAMA 2004;292:1433- 1439)
INIMESE “GIS”
Eric Topol
“The Patient
will see you
now”
OHIO STATE UNIVERSITY MEDICAL CENTRE
Kiitos!
3-10.04.2015 Marathon Des Sables,
Marokkossa 250 km